Neurodevelopmental profiles of infants born <30 weeks gestation at 2 years of age.
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
04
05
2021
accepted:
11
11
2021
pubmed:
10
12
2021
medline:
18
6
2022
entrez:
9
12
2021
Statut:
ppublish
Résumé
Infants born <30 weeks postmenstrual age (PMA) are at increased risk for neurodevelopmental impairment by age 2. Prior studies report rates of impairment for individual outcomes separately. Our objective was to describe neurodevelopmental profiles of children born <30 weeks PMA, using cognitive, language, motor, and behavioral characteristics. We studied 587 children from a multi-center study of infants born <30 weeks PMA. Age 2 outcomes included Bayley-III subscale scores, Child Behavior Checklist syndrome scores, diagnosis of cerebral palsy (CP), and positive screen for autism spectrum disorder (ASD) risk. We used latent profile analysis (LPA) to group children into mutually exclusive profiles. We found four discrete neurodevelopmental profiles indicating distinct combinations of developmental and behavioral outcomes. Two of the profiles included 72.7% of the sample with most having Bayley scores within the normal range. The other two profiles included the remaining 27.3% of the sample with most having Bayley scores outside of the normal range. Only one profile (11% of sample) was comprised of children with elevated behavioral problems. Child-centered analysis techniques could facilitate the development of targeted intervention strategies and provide caregivers and practitioners with an integrative understanding of child behavior. Most studies examining neurodevelopmental outcomes in very preterm children report rates of impairment for individual outcomes separately. Comprehensive, "child-centered" approaches that integrate across multiple domains can be used to identify subgroups of children who experience different types of neurodevelopmental impairments. We identified four discrete neurodevelopmental profiles indicating distinct combinations of developmental and behavioral outcomes in very preterm children at 24 months. "Child-centered" analysis techniques may provide clinically useful information and could facilitate the development of targeted intervention strategies for high-risk children.
Sections du résumé
BACKGROUND
Infants born <30 weeks postmenstrual age (PMA) are at increased risk for neurodevelopmental impairment by age 2. Prior studies report rates of impairment for individual outcomes separately. Our objective was to describe neurodevelopmental profiles of children born <30 weeks PMA, using cognitive, language, motor, and behavioral characteristics.
METHODS
We studied 587 children from a multi-center study of infants born <30 weeks PMA. Age 2 outcomes included Bayley-III subscale scores, Child Behavior Checklist syndrome scores, diagnosis of cerebral palsy (CP), and positive screen for autism spectrum disorder (ASD) risk. We used latent profile analysis (LPA) to group children into mutually exclusive profiles.
RESULTS
We found four discrete neurodevelopmental profiles indicating distinct combinations of developmental and behavioral outcomes. Two of the profiles included 72.7% of the sample with most having Bayley scores within the normal range. The other two profiles included the remaining 27.3% of the sample with most having Bayley scores outside of the normal range. Only one profile (11% of sample) was comprised of children with elevated behavioral problems.
CONCLUSION
Child-centered analysis techniques could facilitate the development of targeted intervention strategies and provide caregivers and practitioners with an integrative understanding of child behavior.
IMPACT
Most studies examining neurodevelopmental outcomes in very preterm children report rates of impairment for individual outcomes separately. Comprehensive, "child-centered" approaches that integrate across multiple domains can be used to identify subgroups of children who experience different types of neurodevelopmental impairments. We identified four discrete neurodevelopmental profiles indicating distinct combinations of developmental and behavioral outcomes in very preterm children at 24 months. "Child-centered" analysis techniques may provide clinically useful information and could facilitate the development of targeted intervention strategies for high-risk children.
Identifiants
pubmed: 34880445
doi: 10.1038/s41390-021-01871-2
pii: 10.1038/s41390-021-01871-2
pmc: PMC9177895
mid: NIHMS1757575
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1579-1586Subventions
Organisme : NICHD NIH HHS
ID : R01 HD072267
Pays : United States
Organisme : NIMH NIH HHS
ID : T32 MH019927
Pays : United States
Organisme : NIH HHS
ID : UH3 OD023347
Pays : United States
Informations de copyright
© 2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
Références
Glass, H. C. et al. Outcomes for extremely premature infants. Anesth. Analg. 120, 1337–1351 (2015).
doi: 10.1213/ANE.0000000000000705
Aarnoudse-Moens, C. S. H., Weisglas-Kuperus, N., van Goudoever, J. B. & Oosterlaan, J. Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics 124, 717–728 (2009).
doi: 10.1542/peds.2008-2816
Stephens, B. E. & Vohr, B. R. Neurodevelopmental outcome of the premature infant. Pediatr. Clin. North Am. 56, 631–646 (2009).
doi: 10.1016/j.pcl.2009.03.005
Allen, M. C. Neurodevelopmental outcomes of preterm infants. Curr. Opin. Neurol. 21, 123–128 (2008).
doi: 10.1097/WCO.0b013e3282f88bb4
Vohr, B. R. Neurodevelopmental outcomes of extremely low birth weight infants <32 weeks’ gestation between 1993 and 1998. Pediatrics 116, 635–643 (2005).
doi: 10.1542/peds.2004-2247
Agrawal, S., Rao, S. C., Bulsara, M. K. & Patole, S. K. Prevalence of autism spectrum disorder in preterm infants: a meta-analysis. Pediatrics. 142, https://doi.org/10.1542/peds.2018-0134 (2018).
Heeren, T. et al. Cognitive functioning at the age of 10 years among children born extremely preterm: a latent profile approach. Pediatr. Res. 82, 614–619, https://doi.org/10.1038/pr.2017.82 (2017).
doi: 10.1038/pr.2017.82
pubmed: 28582386
pmcid: 5909197
Burnett, A. C. et al. Exploring the “preterm behavioral phenotype” in children born extremely preterm. J. Dev. Behav. Pediatr. 40, 200–207 (2019).
doi: 10.1097/DBP.0000000000000646
Cserjesi, R. et al. Patterns of functioning and predictive factors in children born moderately preterm or at term. Dev. Med Child Neurol. 54, 710–715 (2012).
doi: 10.1111/j.1469-8749.2012.04328.x
Bayley N. Bayley Scales of Infant and Toddler Development 3rd edn (Harcourt Assessment, 2006).
Albers, C. A. & Grieve, A. J. Test Review: Bayley, N. (2006). Bayley Scales of Infant and Toddler Development – Third Edition. San Antonio, TX: Harcourt Assessment. J. Psychoeduc. Assess. 25, 180–190 (2007).
Lowe, J. R. et al. Behavioral problems are associated with cognitive and language scores in toddlers born extremely preterm. Early Hum. Dev. 128, 48–54 (2019).
doi: 10.1016/j.earlhumdev.2018.11.007
Achenbach, T. M. & Rescorla L. A. Manual for the ASEBA Preschool Forms and Profiles (University of Vermont, Department of Psychiatry, 2000).
Robins, D. L. et al. Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics 133, 37–45 (2014).
doi: 10.1542/peds.2013-1813
Wurpts, I. C. & Geiser, C. Is adding more indicators to a latent class analysis beneficial or detrimental? Results of a Monte-Carlo study. Front. Psychol. 5, 1–15 (2014).
doi: 10.3389/fpsyg.2014.00920
Helderman, J. B. et al. Antenatal antecedents of cognitive impairment at 24 months in extremely low gestational age newborns. Pediatrics 129, 494–502 (2012).
doi: 10.1542/peds.2011-1796
Moore, T., Johnson, S., Haider, S., Hennessy, E. & Marlow, N. Relationship between test scores using the second and third editions of the Bayley scales in extremely preterm children. J. Pediatr. 160, 553–558 (2012).
doi: 10.1016/j.jpeds.2011.09.047
Månsson, J. & Stjernqvist, K. Children born extremely preterm show significant lower cognitive, language and motor function levels compared with children born at term, as measured by the Bayley-III at 2.5 years. Acta Paediatr. 103, 504–511 (2014).
doi: 10.1111/apa.12585
Doyle, L. W., Roberts, G. & Anderson, P. J. Outcomes at age 2 years of infants <28 weeks’ gestational age born in Victoria in 2005. J. Pediatr. 156, 49–53.e1 (2010).
doi: 10.1016/j.jpeds.2009.07.013
Spencer-Smith, M. M., Spittle, A. J., Lee, K. J., Doyle, L. W. & Anderson, P. J. Bayley-III cognitive and language scales in preterm children. Pediatrics 135, e1258–e1265 (2015).
doi: 10.1542/peds.2014-3039
Greene, M. M., Patra, K., Nelson, M. N. & Silvestri, J. M. Evaluating preterm infants with the Bayley-III: patterns and correlates of development. Res. Dev. Disabil. 33, 1948–1956 (2012).
doi: 10.1016/j.ridd.2012.05.024
Johnson, S. & Marlow, N. Preterm birth and childhood psychiatric disorders. Pediatr. Res. 69, 22–28 (2011).
doi: 10.1203/PDR.0b013e318212faa0
Anixt, J. S. & Wiley, S. Is developmental screening enough in high-risk populations? Pediatrics 147, e2020033043 (2021).
doi: 10.1542/peds.2020-033043
Anderson, P. J. et al. Attention problems in a representative sample of extremely preterm/extremely low birth weight children. Dev. Neuropsychol. 36, 57–73 (2011).
doi: 10.1080/87565641.2011.540538
Fluss, J. & Lidzba, K. Cognitive and academic profiles in children with cerebral palsy: a narrative review. Ann. Phys. Rehabil. Med. 63, 447–456 (2020).
doi: 10.1016/j.rehab.2020.01.005
Kim, S. H. et al. Predictive validity of the Modified Checklist for Autism in Toddlers (M-CHAT) born very preterm. J. Pediatr. 178, e2 (2016).
doi: 10.1016/j.jpeds.2016.07.052
Hofheimer, J. A., Sheinkopf, S. J. & Eyler, L. T. Autism risk in very preterm infants-new answers, more questions. J. Pediatr. 164, 6–8 (2014).
doi: 10.1016/j.jpeds.2013.09.054
Lipkin, P. H. & Macias, M. M. Promoting optimal development: Identifying infants and young children with developmental disorders through developmental surveillance and screening. Pediatrics 145, e20193449 (2020).
doi: 10.1542/peds.2019-3449
Council on Children With Disabilities; Section on Developmental Behavioral Pediatrics; Bright Futures Steering Committee; Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying infants young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics 118, 405–420 (2006).
Sananes, R. et al. Six-year neurodevelopmental outcomes for children with single-ventricle physiology. Pediatrics 147, e2020014589 (2021).
doi: 10.1542/peds.2020-014589